Medically Reviewed by:
John Rabkin, MD, FACSBoard Certified Bariatric SurgeonLast Updated:
The best weight loss surgery options for you depend on:
- How much weight you want to lose
- Your current age, weight, health issues, habits, and lifestyle
- Your expectations for life after surgery
- Whether you want a reversible procedure
- What “trade-offs” you are willing to make
Take the quiz below to find out which bariatric procedures are best for you and why.
TABLE OF CONTENTS
Click on any of the topics below to jump directly to that section
Your Best Weight Loss Surgery Quiz
SECTION SUMMARY:
- Take the quiz to find out which procedure will meet your needs
01 How much weight do you want to lose?
- a.A lot - at least half of my "excess weight", hopefully a lot more. Anything less is unacceptable.
- b.A moderate amount - up to a quarter of my "excess weight" or more would be ideal, and I am open to any procedure.
- c.A moderate amount - up to a quarter of my "excess weight" would be ideal, but I am only interested in procedures that are less involved (less weight loss but quicker recovery & fewer diet and lifestyle changes).
02 Have you thoroughly explored other treatments for obesity?
03 What is your gender?
07 How do you feel about regular visits with a bariatric professional (doctor, dietician, etc.)?
08 How severe are your food cravings?
09 Would the risk of uncomfortable side effects like nausea, vomiting, or diarrhea be a good motivator for you to maintain the right diet, or would you rather avoid those side effects at all costs?
10 Do you have insurance that covers bariatric surgery?
11 Are you on anticoagulation medication (blood thinners)?
12 Are you comfortable with the idea of a special device being left inside your body after surgery, as long as it's safe?
13 How important is having a "reversible" procedure?
14 Are you willing to be on a serious regimen of vitamins and supplements for the rest of your life?
Unfortunately, none of the available types of weight loss surgery seem to be a good fit.
Here's why: Earlier you said that you have not thoroughly explored other treatments for obesity. That is required for all procedures except gastric balloon. Your body mass index ("BMI", which is based on your height and weight) is over 40, and gastric balloon is only available for BMI's between 30 and 40. So unfortunately, none of the available procedures seem to be a good fit.
Unfortunately, none of the available types of weight loss surgery seem to be a good fit for you.
Body Mass Index & Health Conditions
Your body mass index is XX.
In order to qualify for gastric sleeve, gastric bypass, duodenal switch, Gastric Band surgery, your body mass index (BMI) must be 40+ or between 35 and 40 only if you also have weight-related health issues (but you may be able to get approval with a BMI as low as 30).
Gastric balloon requires a BMI between 30 and 40 (with or without health issues).
AspireAssit requires a BMI between 35 and 55 (with or without health issues).
Even though your BMI would qualify you for the gastric balloon, you said anything less than 50% excess weight loss is unacceptable. Unfortuantely, gastric balloon only results in about 20% excess weight loss.
Learn more about Gastric BalloonSince you are or are planning to be pregnant, you should not a weight loss procedure at this time.
Most women should wait least one year to 18 months after bariatric surgery before getting pregnant. This is the timeframe when many patients experience the biggest amount of weight loss, and it is the most difficult period for keeping your body’s nutritional needs in line.
Many bariatric surgery procedures prevent patients from getting the vitamins their bodies need from the foods they eat. So even after you’ve waited the 12 to 18 months, you’ll need to make sure you stay on top of your bariatric vitamins both before and during your pregnancy.
Learn More About Pregnancy After Weight Loss SurgeryYOUR RESULTS
Thank you for completing Bariatric Surgery Source’s "Which Weight Loss Surgery Is Best for You?" quiz! The results are in...
Winner
Gastric sleeve surgery, also called “vertical sleeve gastrectomy”, drastically reduces the size of the stomach which causes patients to feel full sooner and lowers the production of hunger-inducing hormones, leading to significant long-term weight loss and health improvement.
Gastric bypass surgery, also called “ Roux-en-Y gastric bypass”, makes the stomach smaller and reroutes the intestines, causing patients to feel full sooner and absorb less food, resulting in significant long-term weight loss and health improvement.
The endoscopic intragastric balloon, or “gastric balloon,” is a relatively new, non-invasive, and temporary procedure whereby a durable silicone balloon is passed through the mouth, down into the stomach, and filled with saline to make patients feel full sooner, leading to significant short-term weight loss.
It was developed to "bridge the gap" between pure diet and exercise and a more complicated bariatric procedure like gastric sleeve surgery.
The Biliopancreatic Diversion with Duodenal Switch (BPD-DS), or “Duodenal Switch” (DS) for short, deserves more credit and attention than it’s been given. On average, it results in more weight loss than any other procedure.
Its mortality risks are on par with other procedures, and it may be the best procedure for those with a 50+ body mass index (“super-obese”) in terms of average weight loss and elimination of obesity health problems.
However, its higher rate of serious complications and the amount of malabsorption that it causes command careful consideration before moving forward.
Gastric banding (e.g., the LAP-BAND® System) wraps an adjustable band around the upper part of the stomach, causing patients to feel full sooner while eating, lose about half of their excess weight within 2 years, and improve or cure their obesity-related health problems.
Your Projections
After 6 Months:
Lose XXAfter 2 Years:
Lose XXRunner Up
Gastric sleeve surgery, also called “vertical sleeve gastrectomy”, drastically reduces the size of the stomach which causes patients to feel full sooner and lowers the production of hunger-inducing hormones, leading to significant long-term weight loss and health improvement.
Gastric bypass surgery, also called “Roux-en-Y gastric bypass”, makes the stomach smaller and reroutes the intestines, causing patients to feel full sooner and absorb less food, resulting in significant long-term weight loss and health improvement.
The endoscopic intragastric balloon, or “gastric balloon,” is a relatively new, non-invasive, and temporary procedure whereby a durable silicone balloon is passed through the mouth, down into the stomach, and filled with saline to make patients feel full sooner, leading to significant short-term weight loss.
It was developed to "bridge the gap" between pure diet and exercise and a more complicated bariatric procedure like gastric sleeve surgery.
The Biliopancreatic Diversion with Duodenal Switch (BPD-DS), or “Duodenal Switch” (DS) for short, deserves more credit and attention than it’s been given. On average, it results in more weight loss than any other procedure.
Its mortality risks are on par with other procedures, and it may be the best procedure for those with a 50+ body mass index (“super-obese”) in terms of average weight loss and elimination of obesity health problems.
However, its higher rate of serious complications and the amount of malabsorption that it causes command careful consideration before moving forward.
Gastric banding (e.g., the LAP-BAND® System) wraps an adjustable band around the upper part of the stomach, causing patients to feel full sooner while eating, lose about half of their excess weight within 2 years, and improve or cure their obesity-related health problems.
Your Projections
After 6 Months:
Lose XXAfter 2 Years:
Lose XXYour Detailed Results
Click the sections below to learn why you received these results…
Weight Loss
The more "involved" procedures like gastric sleeve, gastric bypass, duodenal switch, and Lap Band aggressively restrict the amount of food your stomach can hold ("restrictive") and/or alter your digestive system to reduce the amount of food your body can absorb ("malabsorptive"). As a result, they are much more likely to lead to weight loss that exceeds 50% of your excess weight.
The less involved restrictive procedures like gastric balloon typically result in a more moderate amount of weight loss.
You said anything less than 50% excess weight loss is unacceptable, so your best options may be the more "involved" procedures like gastric sleeve, gastric bypass, duodenal switch, or Lap Band.
You said you are only interested in less involved procedures, so gastric sleeve, gastric bypass, duodenal switch, and Lap Band are probably not for you. Less involved procedures, including Gastric Balloon or AspireAssist, may be more appropriate.
Failed Diet Programs
Most types of weight loss surgery - gastric sleeve, gastric bypass, duodenal switch, and gastric band, and AspireAssist - are only appropriate for people who have tried and failed with a medically supervised diet program.
Gastric balloon surgery is the only procedure that does not require this.
Talk with your surgeon about how to get started with a supervised diet program.
Failed Diet Programs
Most types of weight loss surgery - gastric sleeve, gastric bypass, duodenal switch, and Lap-Band, and AspireAssist - are only appropriate for people who have tried and failed with a medically supervised diet program.
Gastric balloon surgery is the only procedure that does not require this.
Talk with your surgeon about how to get started with a supervised diet program.
Health Improvement
You indicated that you currently have weight-related health issues, which will likely improve and may even be "cured" following weight loss surgery. Generally speaking, the more weight you lose, the more health improvement you are likely to experience. Following is the average excess weight loss by procedure, from highest to lowest:
- Duodenal switch (65% - 90%)
- Gastric Sleeve & Gastric Bypass (tie at 65% - 75%)
- Gastric Band (45% - 70%)
- AspireAssist (~30%)
- Gastric Balloon (~20%, but removed after 6 months)
However, weight loss and health improvement are not the whole story, and several other factors have been taken into account in our recommendations.
Body Mass Index & Health Conditions
Your body mass index is XX.
In order to qualify for gastric sleeve, gastric bypass, duodenal switch, gastric band surgery, your body mass index (BMI) must be 40+ or between 35 and 40 only if you also have weight-related health issues (but you may be able to get approval with a BMI as low as 30).
Gastric balloon requires a BMI between 30 and 40 (with or without health issues).
AspireAssit requires a BMI between 35 and 55 (with or without health issues).
Patients Under 18
While bariatric surgery is performed on patients under 18 years of age, your surgeon will have several concerns including: whether you are disciplined enough to adhere to strict diet and exercise requirements (many teens are not ready for or cannot prepare for that level of dedication), whether your family and friends will be supportive enough, whether you can properly evaluate the risks vs the rewards of surgery, whether the procedure could potentially affect your growth or bone density (especially malaborptive procedures), and the unknowns about the long-term effect of having an external device in your body (for those procedures like Lap Band). The gastric balloon is not an option as it is currently only allowed for patients over 18.
Patients Between 19 and 21 Years Old
All types of weight loss surgery are available to you except AspireAssist, which requires a minimum age of 22.
Patients Between 56 and 64 Years Old
All types of weight loss surgery are available to you except AspireAssist, which requires a maximum age of 55.
Patients 65 or Older
Since you are 65 or older, it is possible that bariatric surgery is a good option, but you may be less likely to qualify than younger patients due to higher risks.
For example, one study evaluated 100 patients over the age of 65 and found that bariatric surgery for seniors has similar benefits and no additional risks compared to patients under 65. Their results showed that morbidly obese patients over 65 have shorter hospital stays following bariatric surgery than younger patients. The same study showed that after two years older patients lost almost 76% of their excess weight.
However, a much larger aggregate study of over 25,000 patients showed that seniors experience less weight loss and more complications than younger patients and concluded that, "Limiting bariatric surgical procedures to those younger than 65 years is warranted because of the high morbidity and mortality associated with these operations in older patients."
Ongoing Doctor Visits
After the initial surgery, Lap Band and may require several doctor visits to "fine tune" the device to the point that it is just right for you. The other procedures tend to require less long-term follow up doctor visits, including gastric sleeve, gastric bypass, gastric balloon, and duodenal switch. You indicated that seeing your doctor regularly is not an issue for you, so this is just for your information.
Ongoing Doctor Visits
Since avoiding the doctor is important to you, you may want to stick with procedures that tend to require less frequent follow up, including gastric sleeve, gastric bypass, gastric balloon, or duodenal switch. After the initial surgery, certain procedures like Lap Band may require several doctor visits to "fine tune" the device to the point that it is just right for you.
Ongoing Doctor Visits
Since avoiding the doctor is important to you, you may want to stick with procedures that tend to require less frequent follow up, including gastric sleeve, gastric bypass, gastric balloon, or duodenal switch. After the initial surgery, certain procedures like Lap Band may require several doctor visits to "fine tune" the device to the point that it is just right for you.
Food Cravings
There are several reasons people crave food, including food addiction, an overproduction of hunger-causing hormones, and hunger impulses sent from the stomach to the brain. Since food cravings are a big issue for you now, they are likely to continue after surgery unless you choose a procedure that specifically addresses them.
Gastric sleeve and duodenal switch have impressive weight loss and reduce food cravings by completely removing a large portion of your hormone-secreting stomach.
Food Cravings
There are several reasons people crave food, including food addiction, an overproduction of hunger-causing hormones, and hunger impulses sent from the stomach to the brain. Since food cravings are an issue for you now, they are likely to continue after surgery unless you choose a procedure that specifically addresses them.
Gastric sleeve and duodenal switch have impressive weight loss and reduce food cravings by completely removing a large portion of your hormone-secreting stomach.
Dumping Syndrome
For some patients, eating eating foods high in fat, carbohydrates, or sugar, eating foods that are too hot or too cold, or drinking liquids during meals can result in dumping syndrome. Symptoms include bloating, diarrhea, dizziness, heart palpitations, nausea, rapid heart rate, sweating, and vomiting.
While very uncomfortable if it happens, this can actually be a good thing as it provides a very strong deterrent against "cheating" on your new bariatric diet which can lead to better long-term weight loss.
Dumping syndrome is experienced by about 4 out of every 5 gastric bypass patients. The other procedures are much less likely to cause this issue.
Since you indicated that you're open to your body reacting negatively to the wrong diet choices, you may want to keep gastric bypass on your list of possible procedures.
Since you indicated that you don't want to worry about the symptoms associated with dumping syndrome, you may want to remove gastric bypass from your list of procedures to consider.
Insurance
The fact that your insurance covers weight loss surgery is great news, although some individual procedures may not be covered. Even after a new procedure has been proven in the scientific community, it often takes years for insurance companies to add it to their list.
Your policy will probably cover gastric sleeve, gastric bypass, Lap Band, and duodenal switch since they have all been around for a long time.
Gastric balloon and AspireAssist will probably not be covered directly, but your surgeon's office may be able to help you get some of the costs covered. However, these procedures may be covered on a case-by-case basis.
Most top surgeons will help you figure out the cost side of things, including providing a free insurance check and helping you get financing for the part insurance does not cover.
Read the Bariatric Insurance GuideInsurance
You indicated that you're not sure whether your insurance covers weight loss surgery. If you find out that it's covered, note that some procedures may not be included in your policy. Even after a new procedure has been proven in the scientific community, it often takes years for insurance companies to add them to their list.
If your specific policy covers bariatric surgery, it will probably cover gastric sleeve, gastric bypass, Lap Band, and duodenal switch since those procedures have been around for a long time.
Gastric balloon and AspireAssist will probably not be covered directly, but your surgeon's office may be able to help you get part of the procedure costs covered. However, these procedures may be covered on a case-by-case basis.
Most top surgeons will help you figure out the cost side of things, including providing a free insurance check and helping you get financing for the part insurance does not cover.
Read the Bariatric Insurance GuideAnticoagulation Medicine
Since you are currently taking anticoagulation medication (blood thinners), you will have a higher risk of marginal ulcers forming in the new stomach pouch created during a gastric bypass procedure. As a result, if you are on the fence between gastric bypass and a different procedure, you may want to choose the other procedure.
Anticoagulation Medicine
If you are currently taking anticoagulation medication (blood thinners), you will have a higher risk of marginal ulcers forming in the new stomach pouch created during a gastric bypass procedure. As a result, if you are on the fence between gastric bypass and a different procedure, you may want to choose the other procedure.
Implanted Device
Gastric balloon and Lap Band each include a different type of device that is left inside the body. Gastric sleeve, gastric bypass, and duodenal switch do not.
Since you're open to that idea, we haven't given this any weight in our recommendation - we just wanted you to be aware.
Since you are uncomfortable with the thought of a device being left inside your body, you may want to avoid gastric balloon and Lap Band.
Reversible Procedures
Generally speaking, the reversible procedures, including AspireAssist, gastric band, and gastric balloon, do not result in as much weight loss or as much health improvement as the "permanent" gastric sleeve, gastric bypass, and duodenal switch procedures.
However, they do have a few points in their favor:
- Weight loss can still be significant, especially depending on your goals
- They allow you to "stick your toe in the weight loss surgery waters" without taking the full leap, especially when diet and exercise aren't working
- The risk of serious complications tends to be lower
- They can serve as a "bridge" (first step) to a permanent procedure. The more weight you lose before a permanent procedure, the lower the risk of complications and the more long-term weight loss you are likely to achieve.
Since the ability to reverse your procedure is important to you, you should move gastric balloon, AspireAssist, and Lap-Band surgery higher up your list.
Since the ability to reverse your procedure is not important to you, you may want to focus more on other procedure differences like potential weight loss, health improvement, and risks.
Vitamins and Supplements
All weight loss procedures require some level of supplementation, although some are more serious with their requirements than others. The two malabsorptive procedures, gastric bypass and duodenal switch, alter the path of your digestion to prevent your body from absorbing as much food. While this tends to lead to greater weight loss, it also carries with it a higher risk of malnutrition. As a result, you will be on a more robust and stricter vitamin and supplement regimen than with the other procedures.
Since you indicated that you are not willing to be on a serious regimen of vitamins and supplements for the rest of your life, you should think hard about whether weight loss surgery is right for you.
The only procedure that does not require permanent long-term supplementation is gastric balloon because the balloon is usually removed after 6 months.
The "restrictive" procedures (gastric sleeve and gastric band) and aspiration procedure (AspireAssist) tend to lead to much lower instances of vitamin deficiency, but you still may need to be on a more moderate regimen of vitamins since your body will not be able to hold (and therefore absorb nutrients from) as much food.
The malabsorptive procedures (duodenal switch and gastric bypass) require strict, lifelong supplementation, so you should probably avoid those procedures.
Risk of Complications, Hospital Stay and Recovery Time
Any surgery carries risks, and weight loss surgery is no different. Fortunately, weight loss surgery has advanced to the point that the survival rate is extremely high (998+ / 1,000 patients).
However, the risk of minor and serious complications does vary between procedures.
Not surprisingly, three of the “permanent” procedures including gastric sleeve, gastric bypass, and duodenal switch carry a higher risk of serious complications during or immediately after surgery and have a longer hospital stay and recovery time simply because they are more complex and more “invasive” than the other procedures.
The reversible procedures including gastric balloon, and Gastric Band may be less risky up front but either carry a higher risk of long-term complications or are too new to have definitive long-term risk data.
Talk with your surgeon about the pros and cons of each procedure before making a decision.
BACKInsurance and Cost of Surgery
The total cost of surgery varies widely, but what you really care about is your out of pocket costs when all is said and done.
Several factors weigh into this, including whether you have insurance and whether you obtain financing. Most top surgeons will help you figure out the cost side of things, including providing a free insurance check and helping you obtain financing.
BACKCompare All Your Weight Loss Surgery Options
SECTION SUMMARY:
- Compare each procedure to learn important details
- Use the interactive table in this section to compare each procedure
Use the interactive table in this section to compare each procedure:
Alternatively, these pages will help you better understand the differences between popular procedures:
Find a Weight Loss Surgeon
SECTION SUMMARY:
- You can ask a local bariatric practice for a free insurance check or cost quot
- You can attend a free in-person seminar or an online webinar offered by a local weight loss surgeon
- You should schedule a phone or in-person consultation (both often free), if you are interested in learning more about weight loss surgery